New diagnosis & Raw food

Epi4Dogs Foundation Inc.’s mission is the advancement of science and education relating to EPI (Exocrine Pancreatic Insufficiency), yielding useful insights and positive outcomes in better managing EPI in dogs and cats. Our goals are to support and/or collaborate with veterinary EPI research and researchers, and to promote EPI awareness by educating the general public, pet owners, pet organizations, rescue and shelter organizations, veterinary schools and veterinarians.
User avatar
LT_Kaya
Member
Posts: 9
Country: Canada
Pet name: Kaya
My name: LT

New diagnosis & Raw food

Post by LT_Kaya » 13 Apr 2022, 12:17

Hello,

My name's Lucie and my dog Kaya was just diagnosed with EPI ten days ago. Finding this community has been a massive eye-opener and a huge relief to see dogs who are thriving in spite of the condition. We're at the very beginning of our EPI journey so things still feel chaotic and scary. I was hoping to get some feedback on our situation.

Kaya is a 3 1/2 year old GSD mix rescue from up North (we live in Ontario), sweet and easygoing as can be, and my best girl, I adore her so much. Shamefully, it took me weeks to figure out something was wrong. Starting in January, she was always hungry so I increased her portions and though she still didn't put on weight, I didn't worry as our lifestyle had gotten more active, plus with Winter, I thought she was just burning more calories. By mid-March, she was clearly losing weight so I booked an appointment with the vet. That same week, her poo became pale, yellow-ish and the day before the vet appointment, she started having terrible diarrhea. She couldn't make it through the night without needing to go.

We were lucky, the vet's first thought was EPI. She got tested and a week later, it was confirmed. She should be weighing about 59lbs (27kg) and she's now under 44lbs (19.8kg). Since the diagnosis, I followed the vet's advice but having now found this website, I've realised some of it was wrong or not ideal, and as my girl is still losing weight (as of 2 days ago, just under a pound/400g since the diagnosis) I don't know what to trust anymore.

Treatment so far:
  • Metronidazole for 5 days
  • Weekly B12 shots (just got her second one 2 days ago)
  • Off-the-shelf beef pancreas powder (no strength info on it, stop-gap while we waited for vet to order proper enzyme) then Viokase starting 2 days ago
    * With every meal, mixed with warm water, add the food, let rest for 20 minutes
  • 150% of normal food portions in 3 meals per day (sometimes an extra bedtime meal if she behaves as if particularly hungry)
  • FortiFlora with food once a day since ending the Metronidazole
When switching to Viokase, the vet had advised a dosage per meal based on 2 meals a day. As she also advised 3 meals a day for now, I asked whether I should split that dosage over the three meals or increase it proportionally to the number of meals. The answer was that I could just give it for 2 of the 3 meals. Now that I found the information here, it's very clear that this was extremely wrong.

The vet thinks the continued weight loss is due to the food, Kaya is on raw, and that I should switch her to an hypoallergenic kibble. I had switched to raw after trying a long list of kibbles and wet foods that never seemed to agree with her (ear infections, diarrhea, even vomitting in one case) and she would always stop eating them eventually (usually after things seemed to go ok and I bought a bigger bag).

I saw here that some people seem to have good results with raw. I checked the kind I give her and the fat content is under 12% (9% to 11% depending on the protein which I cycle daily) and the fibre is around 3% for all of them. No peas, no grains. I've been wondering whether the issue isn't with the low-grade enzyme I first gave her and I was thinking of giving it another week now that she's on proper stuff but I don't want to delay her recovery unnecessarily.

I'm very conflicted. I want my girl to get better and while I would have preferred to keep her on a diet on which she's previously done great, I understand that the diagnosis changed things. That said, between the Metronidazole prescription and the Viokase dosage discussion, I don't know that I trust my vet with this.

With the wealth of experience in these forums, I was hoping I could get some insights and feedback that would make it easier for me to make the right decision and get my girl back to good health.

Thank you so much

Lucie

User avatar
jilbert57
Staff
Posts: 1490
Country: United States
State: Washington

Re: New diagnosis & Raw food

Post by jilbert57 » 13 Apr 2022, 12:35

Hi Lucie, the dose on the powdered enzymes is 1 level teaspoon enzyme per 1 cup of kibble. Add a little room temperature water and stir. Let set 20 mins, stir and feed. All foodstuffs from now on need to be treated with enzymes before your pup eats it.
That length of Metro would not be long enough. Have you read the information on the Probiotics/Prebiotics in the SID section on the home page? You can try those along with the correct dose of enzyme and see if the SID resolves but if not ask your vet for a 45 day course of Tylan.

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 6 and Sadie is 8months.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

User avatar
LT_Kaya
Member
Posts: 9
Country: Canada
Pet name: Kaya
My name: LT

Re: New diagnosis & Raw food

Post by LT_Kaya » 13 Apr 2022, 13:24

Thank you so much for the super quick response, Jill! Everything I read here said no food should be eaten without the enzyme which is unfortunately the first I'd heard of it. I've been applying that rigorously since finding out.

I did see the SID section but I wasn't sure it applied because she had been on Metro (I also read the Metro horror story and I'm glad she had finished taking it when I did). Is there a way to tell if she still has SID?

Understanding which symptom comes from which issue is confusing. Right now, her poo is still very soft (between 5 and 6 on the scale) but it's back to being brown and there's less of it.

She has had lower energy days (while on Metro she clearly wasn't feeling great) but overall, she's gotten more and more energetic and playful, especially the past few days.

Thank you again for your help, I really appreciate it.
Kaya is a 3.5 y.o. GSD mix. Tested positive for EPI in April 2022. Results: TLI <1, Cobalamin 115, Folate 20.

User avatar
jilbert57
Staff
Posts: 1490
Country: United States
State: Washington

Re: New diagnosis & Raw food

Post by jilbert57 » 13 Apr 2022, 14:35

Symptoms of SID can be acid reflux, spitting, burping, gassy toots, grumbling stomach etc....
Yes the Metro is not easy on the system and can have side effects. The Tylan is more gentle and kills the bad bacteria while leaving the good. Some dogs are on a maintenance dose for life.
Let us know how using the enzymes on all food and Fortiflora go. Good thing you are having the B12 addressed. What food are you feeding? Also will you post the test results for the Tli, B12 and folate? Thanks

Jill
My name is Jill and we live on the Hood Canal in Washington State. We currently have 2 Jack russells, TJ is 6 and Sadie is 8months.

Mickey and his pancreatitis brought me to Epi4dogs.com site in 2012 to help manage it.
He lived from 6/99 - 8/2014

Mickey, Jack Russell. Chronic Pancreatitis. Dianes enzymes, 1/8t 3x/day with meals.

User avatar
Olesia711
Founder & Research Director
Posts: 2502
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis & Raw food

Post by Olesia711 » 13 Apr 2022, 17:37

Hi LT and a very warm welcome to you and Kiya.... it sounds like you have a best friend in Kaya and that you are her human angel! Thank you for writing us!

First Jill gave you great advice, please do give the proper enzymes (Viokase or any porcine/pig pancreatic enzymes that has approx 71,000 USP units of Lipase in it along with approx 80,000 to 495,000 USP units of Amylase and Protease enzymes. It sounds like you were giving incorrect (possibly plant or not potent enough enzymes). Here is a list of proper enzymes: https://epi4dogs.com/enzyme-list/

As mentioned, if giving kibble (dry food) the ratio of enzymes to kibble is 1 tsp of enzymes per 1 cup of food, add enough liquid (water if fine) to moisten the food so that the enzymes have something to stick to, mix the enzymes in the food and then let the enzymes sit in the food for about 20 minutes.

However, if you are feeding raw (or wet food like canned, home cooked, etc) then the ratio of enzymes to wet food is 1/2 tsp to 2/4 tsp of enzymes per cup of food...in the beginning i would go with the heavier dose.

Quite honestly, if Kaya responds well to raw food, continue with the raw food. With many of the difficult EPI cases... many of these dogs did not do well until they were put on raw food... Although that being said, raw food does not agree with all these dogs... so it is up to you and your dog, if raw works. In your case, it sounds like it does, and because of that, i would stick with it.

What you need to do though, is feed 150% for now until all the weight has been gained back or until the dog starts leaving food in it's plate cause it is satiated.
WHat you might want to try is to give a little freeze dried food to make up the extra portion or f a little bit of kibble agrees with her, give one meal with a little bit of kibble (just up the enzymes back to 1 tsp per cup, if you mix and match kibble and raw.
Or just mix and match home cooked and raw............

Also... be sure to feed more food (up it to 150%) BUT.... smaller amounts in a meal so you have to do more meals throughout the day. Every meal has to have enzymes..
NO TREATS ... for now... once things level out... then you can start with treats and we will help you with how to do this with enzymes in , or around the "treats".

Glad you are doing the B12. VERY important. Over 80% of all dogs with EPI need B12 supplementation....

Next... your dog has SID (small intestinal dysbiosis).... They have now proven that ALL dogs with EPI have SID. Our goal is to keep it under good control.
the symptoms of SID out of control is the following: "SID is not under good control if the dog displays any repeated signs such as yellowish or pale colored stools, loose stools, gelatinous stool coating, flatulence, lack of appetite, stomach noises, vomiting, acid reflux, low or low normal B12 then treat for existing secondary SID/SIBO"..... i read that you are giving Forti Flora.... which is okay... but if you do not see improvement.... then ask your vet to prescribe Proviable or Visbiome instead... or, go on line and another good probiotic (at this time... things are always changing) is Vetri Science Mega Probiotics.

Glad that the course of Metro is over..... however.... if the probiotics mentioned above doesn't produce good stools... then go ahead and tell your vet to put Kaya on Tylan. It will need to be given by weight, twice a days with breakfast and dinner... and for 45 days. But do try to get SID under good control first with just the pre+probiotics mentioned here if you can, if not, then go for the Tylan.

Also... when starting / implementing ANY probiotic... ALWAYS start with less than 1/2 the recommended dose and work your way up to a full dose over the course of a week or two. the reason for this is sometimes some dogs can't handle a full dose of probiotics all at once and will have loose stools... not something an EPI needs to deal with... they have enough issues as it is.... so start slow and work your way up.

And last but not least.... please know that just by being here and chiming in... you are being the best care-taker for Kaya. The majority of our recommendations follow Texas A&M Gastrointestinal Lab at TAMU.... Epi4Dogs has also collaborated on various EPI or related research with multiple vet schools such as TAMU, Univ of Ill, Clemson Univ and various vet schools in Europe, etc but sometimes it's the little tips and tricks that are practical applications that make that final positive change that is expected

... remember... EPI doesn't happen over night.... it took a long time brewing..... We don't even notice anything is wrong until AFTER 85 to 95% of the exocrine Pancreas has atrophied....so recovery will also take a little time.

Please continue to keep us posted and we will work with you step by step. And be sure to share with your vet everything we suggest. If anything is questioned, please look at the research (there are topic research sections under most of the individual topic tabs) and or the vet seminars give y the researchers https://epi4dogs.com/epi-seminar/ given on EPI is also a good source. In short, everything we suggest is recommended or supported by vet research..

Hope this helps and please keep us posted.
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
LT_Kaya
Member
Posts: 9
Country: Canada
Pet name: Kaya
My name: LT

Re: New diagnosis & Raw food

Post by LT_Kaya » 14 Apr 2022, 11:58

Thank you so much I really appreciate the help and all the kind words.

She hasn't had acid reflux, spitting or burps but she has been gassy. It's improved a lot in the past few days. She finally had a properly formed poo this morning though it was very beige.

This morning, for the first time in a long while, she waited very patiently for her breakfast to be ready rather than try and hurry me up which made me feel very hopeful. I added a small bedtime meal which might have helped. That makes it 4 meals a day for between 150% and 175% of what she should be eating.

I'm hopeful things might be improving. I'll update either way as we go.

Thank you again :)
Kaya is a 3.5 y.o. GSD mix. Tested positive for EPI in April 2022. Results: TLI <1, Cobalamin 115, Folate 20.

User avatar
Olesia711
Founder & Research Director
Posts: 2502
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis & Raw food

Post by Olesia711 » 14 Apr 2022, 12:44

YES!!! a very positive update.... Keep up the good work and please do keep us posted. Just know that sometimes when first dealing with EPI it's like 2 steps forward and 1 step backward.... but don't get discouraged... this happens and we will try to help you as best we can navigate EPI :)
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
LT_Kaya
Member
Posts: 9
Country: Canada
Pet name: Kaya
My name: LT

Re: New diagnosis & Raw food

Post by LT_Kaya » 25 Apr 2022, 16:09

3 weeks update: she's putting on weight! She went from 19.8kg (43.5 lbs) 2 weeks ago to 20.5kg (45.2 lbs) today. Not a lot but it's the right trend and a huge relief!

Current protocol:
  • Still on raw food, about 175% of her normal feeding across 4 meals per day
  • 3 tsp of enzyme per pound of food
  • Fortiflora once a day (will transition to Proviable once I receive it)
  • B12 injections once a week
I'm so grateful for all the information on this website and the words of encouragement and support. I was so scared when things didn't improve the first little while and she kept losing weight and it was a relief finding this community. Thank you.
Kaya is a 3.5 y.o. GSD mix. Tested positive for EPI in April 2022. Results: TLI <1, Cobalamin 115, Folate 20.

User avatar
Olesia711
Founder & Research Director
Posts: 2502
Location: North Carolina
Country: United States
State: North Carolina
Pet name: Izzy
My name: olesia

Re: New diagnosis & Raw food

Post by Olesia711 » 25 Apr 2022, 20:30

WAHOO!!!!!!!!!!!!! What a great positive report.

Putting on weight in 3 weeks is pretty darn good.

We often tell folks the FIRST thing you want to focus on is stopping the loose stools..... then focus on the weight gain. Considering it's only been 3 weeks, and that she started off with incorrect protocol... to already gain some weight in week 3 is excellent.

Looking forward to hearing more positive reports!
Olesia, was owned by Izzy, a 35lb Spanish Water Dog (SWD), Diagnosed at 1.5 years old - TLI results 1.. Izzy passed away on February 13, 2020 at 15 years old. She lived with EPI for 13+1/2 years. It was because of Izzy that Epi4Dogs was started... she was the inspiration. May her legacy of helping others with EPI continue for as long as needed.........

User avatar
LT_Kaya
Member
Posts: 9
Country: Canada
Pet name: Kaya
My name: LT

Re: New diagnosis & Raw food

Post by LT_Kaya » 26 Apr 2022, 18:44

Huge relief!

Her poo got good very quickly once I followed all the advice. It took less than a week for it to be normal, so it's been about a week now without any issues. Fingers crossed it continues.

She does have some very stinky flatulence and days here and there with tummy noises so I'm looking forward to trying the Proviable to see if it helps.

I'm so grateful this place exists or I would have been looking at her get worse without a clue as to why. Thank you so much.
Kaya is a 3.5 y.o. GSD mix. Tested positive for EPI in April 2022. Results: TLI <1, Cobalamin 115, Folate 20.

Post Reply

Who is online

Users browsing this forum: No registered users and 2 guests